Mario Ivan Galiano-Cevallos, P.A

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9100820 Issued in FL

Practice address

4469 S Congress Ave Ste 106
Lake Worth, FL 33461-4726

Phone

(561) 642-0768

Fax

(561) 642-0769

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Guadalupe Medical Center Inc

  • Family Medicine Physician
  • Lake Worth, FL
  • NPI 1861504342
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710099213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4469 S CONGRESS AVE STE 106",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334614726",
            "telephone_number": "561-642-0768",
            "fax_number": "561-642-0769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4469 S CONGRESS AVE STE 106",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334614726",
            "telephone_number": "561-642-0768",
            "fax_number": "561-642-0769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALIANO-CEVALLOS",
        "first_name": "MARIO",
        "middle_name": "IVAN",
        "credential": "P.A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9100820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "291336400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacques Gabriel
• Sebastian Gabriel
• Mercedes Gadea Lopez, M.D.
• Gait Mechanics, Inc
• Galena ABA Speech & OT LLC
• Michelle Galloway, LCSW
• Yurelsy Galvez Ricardo, MD
• Emmette Thomas Gamble Jr., PHARM D.
• Florence Gamble
• Pickens Allison Gantt III, LAC

• Physician Assistant in Lake Worth, FL
• Providers in Lake Worth, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.